鼻咽癌患者氟尿嘧啶药时曲线下面积与近期疗效及不良反应的相关性分析  

Correlation of area under the curve with short-term effect and adverse reactions of 5-Fu in patients with nasopharyngeal carcinoma

作　　者：蔡传书[1] 王培荣[1] 黄雄[1] 

机构地区：[1]福建医科大学附属第一医院放疗科

出　　处：《中国临床药理学与治疗学》2016年第12期1394-1398,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:探讨鼻咽癌患者氟尿嘧啶(5-Fu)药时曲线下面积(area under the curve,AUC)与不良反应及近期疗效的相关性。方法:56例鼻咽癌患者,接受含5-Fu化疗方案,于静脉泵注开始后18~30 h采集外周静脉血测定5-Fu血药浓度,计算AUC。比较AUC≥20 mg·h·L^(-1)组和AUC<20 mg·h·L^(-1)组的疗效差异,分析AUC≤30 mg·h·L^(-1)组和AUC>30 mg·h·L^(-1)组的不良反应发生情况。结果:56例患者平均和中位AUC分别为19 mg·h·L^(-1)和23 mg·h·L^(-1)。其中AUC≥20 mg·h·L^(-1)组有效率较AUC<20 mg·h·L^(-1)组高(85%vs 60%,P<0.05)。AUC>30 mg·h·L^(-1)组Ⅰ~Ⅱ级谷丙转氨酶升高、Ⅲ~Ⅳ级骨髓抑制(18%、59%)均高于AUC≤30 mg·h·L^(-1)组(3%、13%)(P<0.05)。结论:鼻咽癌患者5-Fu的AUC值在20~30 mg·h·L^(-1)时,患者近期疗效较好且不良反应较低。AIM： To explore the correlation of area under the curve（ AUC） with short-term effect and adverse reactions of 5-Fu in patients with nasopharyngeal carcinoma. METHODS： 56 patients were enrolled with nasopharyngeal carcinoma in this study. Blood samples were collected after 18 to 30 h infusion of 5-fluorouracil（ 5-Fu） to detect the serum concentration of 5-Fu and calculate area under the curve value. The effect was compared between AUC≥20 mg·h·L^-1 group and AUC 20 mg·h·L^-1 group. The incidence of adverse reactions were analyzed in AUC≤30 mg·h·L^-1 group and AUC 30 mg · h · L^-1 group. RESULTS： The average and median level of AUC were 19 mg·h·L^-1 ,23 mg·h · L^-1 in 56 patients,respectively. The response rate was significantly higher in AUC ≥20 mg ·h ·L^-1 group than that in AUC 20 mg ·h ·L^-1 group（ 85% vs 60%,P〈0. 05）. The incidence of increase of glutamic-pyruvic transaminase in Ⅰ-Ⅱlevel and myelotoxicity in Ⅲ-Ⅳ level were significantly higher in AUC ≥30 mg · h · L^-1 group than that in AUC 30 mg·h·L^-1 group（ 18%,59% vs3%,13%,P〈0. 05）. CONCLUSION： The patients with nasopharyngeal carcinoma will obtain optimal effect and less toxicities when the AUC of 5-Fu maintains from 20 to 30 mg·h·L^-1 .

关 键 词：氟尿嘧啶 AUC 鼻咽癌 疗效 不良反应 

分 类 号：R969.1[医药卫生—药理学]